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General NPI Number Information
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NPI Number | 1386832681
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Entity Type | Individual
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Provider Name | JENNIFER LYNN FORBES PA
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Gender | Female
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 1141 N ROAD ST SUITE G
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3354
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Country | US
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Telephone | 252-335-5424
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Fax | 252-335-1077
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Provider Business Mailing Address
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Address Line | 1141 N ROAD ST SUITE G
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3354
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Country | US
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Telephone | 252-335-5424
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Fax | 252-335-1077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 470
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001001368
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License Number State | NC
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